Thick narrative virtual patient simulations use rich media and clinical storytelling to immerse learners in realistic contexts that provide holistic viewpoints of patients. This case study showcases a thick narrative simulation that uses video, branching, reflection and discovery learning to explore communication strategies for facilitating difficult conversations. While treating their virtual patient, learners are provided with just-in-time information about a communications model they will use to guide patient discussions. Branching implements an instructional strategy that builds conceptual knowledge through the exploration of matched examples and non-examples. With this approach, learners experience both an example of best practice and opposite sub-optimal approaches, or non-examples. Just like a “choose your own adventure” book, learners select what question to ask the patient next. One choice sends learners down an optimal path that models best practice, while other choices send learners down less than optimal approaches. With this branching design, learners observe the conversation go very well, or not so well. In each case, learners are encouraged to reflect on the interview, and identify what factors contributed to the outcome. The presentation will review a template for matched examples and non-examples that can be used for a variety of virtual patient simulations.

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